Is Nipple Reduction What I Need?
Q: Dr. Eppley, I am curious about nipple reduction. I am an athlete with only about 10-12% body fat but I have nipples that stick out. I have always been self-conscious about the kind of shirts I wear or even taking my shirt off. I would like more information on what is best for my situation.
A: When one is concerned about nipples that stick out, it is very important to differentiate between true nipple protrusion and areolar gynecomastia. Both can cause protrusion from the nipple area but they appear quite differently on close inspection anad are treated with different techniques.
The commonly called nipple is really better understood as the nipple-areolar complex. There is a central protruding nipple surrounded by a flat pigmented areola. In men, the nipples are smaller because the size (diameter) of the areola is very small. In nipple protrusion or hypertrophy, the small central nipple sticks out while the surrounding areola is flat. This makes for a small point that sticks out in shirts. It is treated by a simple nipple reduction done under local anesthesia in the office. Most of the nipple is removed so it lays flat and will never protrude again. In areolar gynecomastia, there is a mass of breast tissue that pushes out the whole nipple-areolar complex. This is better called a ‘puffy nipple’. It is treated by removing this mass of breast tissue through a small areolar incision. This is done as an outpatient procedure under IV sedation or general anesthesia.
Dr. Barry Eppley